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A Tried and Tested Prescription
A ship’s crew
is not immune to illness or injury on board. The ship’s dispensary
needs to contain reliable medications and other medical articles. Lagaay
International, a ship’s medical supplier, is the market leader in
stocking, maintaining and certifying ship’s medical lockers. Using
its Medical Care System, Lagaay works in accordance with the maritime
regulations of numerous flags.
By
Rob Schoemaker
Proper medical care
on board seagoing ships is not only a matter of humane treatment, but
of economic importance. Rationalization in the shipping industry during
the past few decades has led to a decrease in the number of people on
board with specific, difficult to take over duties. Lost time due to illness
and injury place a heavy burden on coworkers.
In the event of medical problems, a ship can use its radio to get professional
help, but the required medicine must be on board, of course. The laws
of the flag under which a ship sails determines which medicines and supplies
must be stored in a ship’s medical locker. Other factors that play
a role are the size of the crew, the type of cargo (dangerous goods) and
the route the ship sails.
In addition, medicines are perishable goods and must be replaced before
their expiration date. In short, managing a ship’s dispensary is
a complex and time-consuming matter that carriers prefer to outsource.
Lagaay International, a specialized ship’s medical supplier based
in Rotterdam, answers specifically to these needs with its Medical Care
System. This system has helped to make Lagaay the world’s market
leader.
Complex issues
“The roots of Lagaay International are in Apotheek Lagaay which
is 124 years old and has been supplying medicine and medical supplies
to the shipping industry for forty years,” states managing director
Boris Noordervliet. “Lagaay started in the port of Rotterdam. The
previous owner, Krijn van Schagen, was sharp to notice that the leadership
on board and at the shipping companies was happy to be relieved of the
complex issues regarding medicines on board. In 1996, he introduced the
Lagaay Medical Care System, which quickly grew to become a unique selling
point. The company’s location in Rotterdam is another advantage.
This region is the heart of ship movements in the world.”
At present, the company has data on more than 12,500 ships. The system
contains such data as expiration dates and other information about the
pharmaceuticals on board. “We use this information to check, manage,
re-stock and to issue our Lagaay certificate, which verifies that everything
in the medical locker is in order. We also arrange local delivery of special
items such as narcotics. We supply throughout the world from basically
every port. One a ship is entered into our system, we do not have to go
on board personally every time to issue our certificate. But we do like
to visit every ship every two or three years, preferably when the vessel
is docked in a Dutch or Belgian port.”
Outdated
Lagaay has been operating in the large Scandinavian market for ten years
now and the company supplies no less than three-quarters of the sizeable
Norwegian and Danish fleets. After taking over local competitor Van der
Laan Mediscore in 2000, Lagaay is strong in the Dutch market as well.
Noordervliet: “Our pharmacy supplies several million items (medicine
and non-medicine) each year, but use on board is not very high as a rule
– on average, no more than three to five per cent of stock annually.
Use is generally a result of emergencies. National regulations governing
ship’s dispensaries are not amended often. As a consequence, medicine
stocks on board can be quite an outdated cliché: pain relievers,
muscle ointments, vitamin tablets. Only the Scandinavian and Dutch regulations
have been brought up-to-date recently, so those ships also have modern
medicines as well.”
Raise a new flag
A popular move in the shipping sector for some years has been to re-register
ships under new flags. That often means that the contents of the ship’s
medical locker need to be altered according to the applicable maritime
regulations. And not just new medications – new labels as well.
All medicine labels must be in two languages – the language of the
regulations and English. There are flags representing no less than 357
different nations and territories, although many smaller jurisdictions
follow the maritime regulations drawn up by the World Health Organization
(WHO).
Noordervliet: “If we notice an up and coming flag in the market,
we respond to that in our pharmaceutical services. But we do more. We
use colored-code labels according to medicine groups, for example, in
order to reduce the chance that the wrong kind of pills are grabbed in
an emergency. In addition, we also try to function in an advisory capacity
for our customers. We are more than just a delivery truck.”
Because medicines are used infrequently on board, it is important that
they have a long shelf life. “The shipping companies ask for that.
We look for the latest expiration dates, too, and that doesn’t always
please our suppliers. We guarantee an expiration date at least a year
away. It actually turns out to be two years or more for 96 per cent of
the medicines we supply, and that can be as long as seven to eight years.”
High fines
Other items besides the legally stipulated medications can be found in
a ship’s medicine locker. What these items are depends on the carrier.
“These days, in the Al Qaida era, an anti-anthrax agent is rather
the rage. And surgical masks are almost impossible to keep in stock –
SARS, of course. Together with the radio medical advisors, we advise carriers
and legislators as to worthwhile additions. Since more and more women
can be found among the crewmembers, a pregnancy test has been included.
Generally speaking, it is always cheaper to have the medicine on board
than to find it lacking”, states Noordervliet.
If an accident happens on board, communication between the officer on
duty and the radio medical advisor takes place. The advisor refers to
the sailor’s medical file (required for all crewmembers), inquires
as to symptoms, asks about the flag and legislation and then informs the
ships what can be found where in the medical locker. If it is not stocked
according to the legislation of the flag, or if the contents are not systematically
arranged, a dangerous situation could be the result.
The right stock systematically organized is essential for another reason.
Inspections can result in extremely high fines if the required items are
not present or if medicines are overdate. Noordervliet: “Even worse,
in some ports, authorities will sometimes try to profit from this. As
a precautionary measure, a captain once put the entire medical locker
in the ship’s safe when the vessel called into a West African port.
Normally, the only medicines kept in the safe are narcotics. During a
previous visit, even the Vaseline was counted as a narcotic by an inspector
bent on issuing fines.”
From
Bandages to Operating Rooms
Lagaay International,
led by three executives since 2000, has doubled its turnover in the last
three years. Twenty-five employees, including two pharmacists, supply
medicine seven days a week, 24 hours a day.
Lagaay not only serves the cargo transport sector, but the cruise industry
as well. Deliveries can be quite extensive and including x-ray machines,
body bags, operating rooms, defibrillators and analysis material. The
offshore industry is another growth market. Every platform has a physician
or paramedic on duty and an infirmary. The nature of the work on a platform
and the larger numbers of people working there mean that there are more
accidents.
“Nowadays, we make only a half per cent of the medicines ourselves
and the rest we purchase,” says managing director Boris Noordervliet.
“We keep meticulous records of what we supply from which manufacturers
and suppliers. If a supplier should make a mistake, using the batch number
we are able to inform a ship anywhere in the world within half an hour
that the medicine has been recalled. Fortunately, we’ve never had
to do that.”
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